| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $109.68 | $119.01 | $127.51 | |
Cigna
| Facility | $166.52 | $166.52 | $166.52 | |
Cigna
| Professional | $121.56 | $121.56 | $166.52 | |
United
| Professional | $120.05 | $143.06 | $200.28 |